Individual
DR. MATTHEW DOUGLASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
50 N MEDICAL DR, SALT LAKE CITY, UT 84132-5524
(402) 559-6329
Mailing address
295 S CHIPETA WAY, SALT LAKE CITY, UT 84108-1287
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
10341688-1204
UT
Other
Enumeration date
06/24/2014
Last updated
10/20/2021
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